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自发性膀胱破裂具有病情复杂、症状多变的特点,临床上容易误诊.1976年以来经治8例,其中误诊5例,现报告如下.1 临床资料本组男6例,女2例.年龄14～70岁.导致膀胱破裂的因素:病理性膀胱2例(膀胱炎1例,结核1例),下尿路梗阻4例(前列腺增生3例,膀胱憩室1例),酗酒致尿潴留1例,急性脊髓炎致膀胱麻痹1例.全部病例皆属腹膜内型膀胱破裂.破裂口除1例位于左侧壁外,其余皆位于膀胱顶部.膀胱破裂的临床表现:血尿2例,膀胱刺激症状6例,突发性腹痛6例,腹膜炎表现8例,排尿困难7例,休克4例.全部经腹腔穿刺,其中2例抽出血性液体,2例抽出脓血性液体,4例抽出淡黄色混浊液.膀胱注液试验3例,结果阳性2例,假阳性1例.本组有5例误诊,误诊为阑尾炎穿孔1例,胃穿孔1例,肠扭转1例,脾破裂1例,肠系膜血管栓塞1例.8例均行剖腹探查,其中7例经腹腔引流,修复膀胱裂口,治愈出院.另1例行二次手术治愈,无死亡病例.
Spontaneous bladder rupture with complex disease, the characteristics of changeable, easily misdiagnosed clinically since 1976, 8 cases, of which 5 cases were misdiagnosed, are as follows.1 Clinical data The group of 6 males and 2 females.Ages 14 to 70 years old.The factors leading to bladder rupture: pathological bladder in 2 cases (cystitis in 1 case, tuberculosis in 1 case), lower urinary tract obstruction in 4 cases (benign prostatic hyperplasia in 3 cases, bladder diverticulum in 1 case), alcohol to urinary retention 1 Cases, acute myelitis caused by paralysis of the bladder in 1. All cases were intraperitoneal bladder rupture, except one case of rupture in the left wall, the rest are located in the top of the bladder Bladder clinical manifestations: hematuria in 2 cases, bladder irritation Symptoms in 6 cases, 6 cases of sudden abdominal pain, peritonitis in 8 cases, dysuria in 7 cases, shock in 4. All by abdominal puncture, of which 2 cases of hemorrhagic fluids, 2 cases of pus and blood drawn, 4 out of pale yellow turbidity Fluid bladder injection test in 3 cases, the results were positive in 2 cases, false positive in 1. In this group, 5 cases were misdiagnosed as misdiagnosed as appendicitis perforation in 1 case, gastric perforation in 1 case, intestinal torsion in 1 case, splenic rupture in 1 case, mesenteric vascular Embolization in 1 case .8 cases underwent exploratory laparotomy, of which 7 cases of abdominal drainage, repair of the bladder gap, cured and discharged .One case of second hand Cure, no deaths.